One difference could be the length of time between the program intervention and the measured outcome, however the most important difference is the effect the intervention has on the outcome. Short-term outcomes can be directly tied to the intervention, while long-term outcomes can be less directly attributed to the program. In general, short-term outcomes are measured at the end of the program or soon after the program has finished. Short-term outcomes refer to changes in knowledge, attitudes, or behaviors and can include reports of behaviors that participants intend to change or motivation to change. Intermediate outcomes are usually measured within several months after the end of the program and include actions by participants based on what they learned. Long-term outcomes are measured a year or several years after program completion and include changes in conditions, policies, or organizational structure. For example, a short-term outcome for a smoking prevention program for teenagers could be the number of teens who report that they do not plan to start smoking. An intermediate outcome could be the number of teens who report not smoking at six months, and a long-term outcome could be a reduction in the smoking rate among teens in a city, county, state or region. Short-term, intermediate, and long-term outcomes are related and build on each other.